Award Date


Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Committee Member

Jessica Doolen

Second Committee Member

Du Feng

Third Committee Member

Hyunhwa Lee

Fourth Committee Member

Lisa Bendixen

Number of Pages



Family nurse practitioner (FNP) programs represent almost 60% of all accredited primary-care NP programs in the U.S. in 2015. Increased enrollments and creation of new NP programs has led to a shortage of appropriate clinical sites and the increased competition for quality clinical sites. FNP programs have turned towards utilizing innovative ways to address this shortage including the use of high-fidelity simulation. However, a lack of literature supports substituting traditional clinical hours with high-fidelity simulation. Only 45 articles were found over a 35-year period describing the use of high-fidelity simulation in an FNP program and of those published since 2014, only 17 FNP programs were represented.

The purpose of this study was to examine the prevalence and use of high-fidelity simulation in FNP programs in the U.S. during the 2017-2018 academic year. METHODS: This study used a descriptive survey-research methodology. The survey was sent to 377 FNP programs from August 2, 2018 to October 6, 2018. A total of 131 programs (34.7%) participated in this study. Among participants, 112 (85.5%) reported using one or more types of high-fidelity simulation in their program.

High-fidelity simulation is used in an average of three courses per program; the most common course being advanced health/physical assessment. Programs have an average of 36 high-fidelity simulation hours per program, an average of 10 hours per course, and 1.48 hours per high-fidelity simulation. The most common category of high-fidelity simulation topic required by programs are cardiac topics, yet the most common individual topic required was diabetes management. The majority of courses (68.6%) reported using one type of high-fidelity simulation per course. Standardized patients (SPs) was the most common type of high-fidelity simulation modality used in courses. Programs reported a variety of sources for SPs, the most common being professional SPs. The most common computer-based simulation program reported was Shadow Health. More than half (55.4%) conduct their high-fidelity simulations in their school of nursing simulation center/learning laboratories. Only 28.2% reported using high-fidelity simulation towards clinical hours with a range of 6 to 100 hours. However, 53.9% of participants stated they would substitute 5-25% of traditional clinical hours with high-fidelity simulation, if allowed. Qualitative analysis of reported perceived benefits from using high-fidelity simulation revealed it has a positive impact on preparedness with subthemes of effective teaching tool, facilitates role transition, evaluation of student/cohort/program, and reduced preceptor burden.

No previous simulation survey has focused specifically on FNP programs. Results of this study showed a wide variety of uses and practices of high-fidelity simulation, positive perceived benefits from using high-fidelity simulation, and a desire to increase the use of high-fidelity simulation within programs. Results from this study may help focus future discussions and research studies to help advance the state of the science, which could improve quality of programs, ensure quality of student learning, and possibly yield creative solutions to addressing clinical site and preceptor shortages.


Family nurse practitioner; Graduate student; Nursing education; Simulation



File Format


Degree Grantor

University of Nevada, Las Vegas




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